Keto And Canker Sores: Is There A Link?

Canker sores are a painful ailment that can make everyday activities such as eating or talking uncomfortable. While the exact cause of canker sores is unknown, there are several factors that are thought to contribute to their formation, including vitamin deficiencies, stress, and dietary changes. Some individuals who adopt a ketogenic diet may experience a flare-up of canker sores due to the drastic reduction in carbohydrate intake and the associated increase in stress on the body. Additionally, the ketogenic diet may lead to vitamin B12 and folate deficiencies, which are known to increase susceptibility to canker sores. However, the ketogenic diet is also praised for its ability to reduce inflammation and minimize sugar intake, both of which may help prevent canker sores.

Vitamin B12 deficiency

Canker sores are painful yellow or white sores inside the mouth. They usually form on the insides of the cheeks, lips, or tongue, and can make everyday activities such as eating or talking uncomfortable. Canker sores are not contagious, but they are common, affecting about 20% of people, especially teenagers and young adults.

While the exact cause of canker sores is unknown, experts think that genetics, smoking, injury, stress, food allergies, and vitamin B12 and folic acid deficiencies can all play a role.

Vitamin B12 is a key nutrient that the body needs for blood cell reproduction and for protecting the nervous system from vision problems and memory loss. A vitamin B12 deficiency affects about 6% of adults under 60 years, with the risk in people over the age of 60 approaching 20%. It is often caused by eating a diet that does not include any (or few) animal-based products or because your body has trouble absorbing nutrients. Other causes of a vitamin B12 deficiency include digestive disorders (e.g., Crohn's and celiac disease), following a strict vegan or vegetarian diet, certain medications (e.g., metformin, gastric acid inhibitors, oral birth control), and drinking a lot of alcohol.

A daily dose of vitamin B12 may help prevent recurring canker sores. Topical vitamin B12 can also lessen canker sore pain. However, vitamin B12 is not the first line of treatment for oral health professionals when it comes to treating canker sores, as the data is limited. Nevertheless, if you get a lot of canker sores or get them often, it may be worth talking to your healthcare provider about a possible vitamin B12 deficiency and considering OTC and prescription products that are effective at treating canker sores.

Excretion of acetone

Acetone is the smallest ketone body, which is produced naturally in our bodies when we enter and sustain a ketone-burning state called ketosis. It is also produced synthetically in labs and used in household products such as nail polish remover and glassware cleaner.

When the body enters ketosis, water-soluble molecules called ketone bodies or "ketones" are released. The three ketones are: acetoacetate, beta-hydroxybutyrate, and acetone. Acetoacetate is created first, followed by beta-hydroxybutyrate, and then acetone, which is created spontaneously from the breakdown of acetoacetate.

Acetone is the simplest and most volatile ketone. It diffuses into the lungs and exits the body when you exhale. It can also be excreted through urine and sweat. The presence of acetone in the breath is known as "keto breath" and is characterised by a faint nail polish or overripe fruit smell.

While acetone is safe when produced internally, it is considered a toxic and volatile organic compound when sourced externally. Therefore, it is important to practice chemical safety when dealing with acetone. Exposure to acetone can cause adverse health effects, with high concentrations leading to acetone poisoning.

To prevent acetone poisoning, it is recommended to wear protective gloves and clothing and ensure the space is well-ventilated. If acetone comes into contact with the skin or eyes, it is best to remove any contaminated clothing and flush the area with water.

In summary, acetone is a natural byproduct of ketosis and is mostly excreted through the breath. Its presence indicates that the body is producing ketones and reaping the benefits of the ketogenic diet.

Dehydration

The increased urination and sweating caused by dehydration can lead to a loss of electrolytes, including sodium, potassium, and magnesium. This loss of electrolytes can have several negative effects on the body, including an increased risk of muscle cramps, irregular heart rhythm, and kidney damage.

To prevent dehydration and the associated negative effects, it is important to ensure adequate fluid and electrolyte intake. This can be achieved by drinking plenty of water and other fluids, and by consuming electrolyte-rich foods or supplements.

It is also worth noting that dehydration can be a cause of stress on the body, and stress is a major factor in the development of canker sores. Therefore, it is possible that dehydration may indirectly contribute to the occurrence of canker sores in individuals on a ketogenic diet.

However, it is important to note that there is no conclusive evidence that a ketogenic diet causes canker sores. While some individuals may experience a flare-up of canker sores after starting this diet, others may find that the reduced inflammation and sugar intake associated with the keto diet help to prevent or alleviate canker sores.

Sodium Lauryl Sulfate (SLS) in toothpaste

While there is no conclusive evidence that keto causes canker sores, some people who adopt this diet do experience a flare-up. One theory is that the keto diet may cause canker sores due to the increased stress of drastically changing diets. Another theory is that the excretion of acetone, a ketone body, from the breath during the keto-adaptation period may be the culprit.

One way to help reduce the occurrence of canker sores when on the keto diet is to switch to a non-SLS-containing toothpaste. Sodium Lauryl Sulfate (SLS) is a common ingredient in toothpaste that helps thicken the formula, create a foamy texture, and dissolve dental plaque. However, SLS has been known to cause some issues, particularly for those who suffer from stomatitis or mouth sores. The National Institutes of Health (NIH) reports that SLS toothpaste will increase irritation for those with mouth sores, while non-SLS toothpaste will help reduce pain.

Additionally, SLS limits the bioavailability of fluoride, which is the primary goal of toothpaste. This means that the effectiveness of the toothpaste is reduced. Some studies have also shown that SLS can increase the incidence of aphthous ulcers.

Overall, while SLS is considered safe by the FDA and EPA, it may be a good idea for those suffering from canker sores to switch to a non-SLS toothpaste to help reduce irritation and increase the effectiveness of the toothpaste.

Stress

While the exact cause of canker sores is unknown, emotional stress and fatigue are believed to be potential triggers. Canker sores, also known as aphthous ulcers, are small, round, and often painful lesions that develop in the soft tissues of the mouth. They usually heal within a week or two but can be irritating.

Canker sores often occur during times of stress and are more common in women, especially around their menstrual periods. They are also more likely to occur in those with a family history of canker sores. A combination of emotional stress and fatigue can create the perfect environment for canker sores to develop. Interestingly, some people may not realise the connection between their canker sores and stress, as the sores sometimes appear several days after a stressful event or situation.

If you suspect that your canker sores are linked to stress, learning to recognise and manage your stress triggers may help prevent future flare-ups. Managing stress can also positively impact your overall oral health, as there is a potential link between stress and gum disease.

There are several techniques to reduce stress, such as deep breathing exercises and meditation. If your stress levels are consistently high, you may need to make more significant changes, like reducing your workload or seeking additional support. Always consult a medical professional before making any major lifestyle changes or if you feel overwhelmed.

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